Conservative Treatment in Lateral Elbow Pain

Keijsers, Renée; Eygendaal, Denise

doi:10.1007/978-3-662-48742-6_11

Cited by 2 publications

(1 citation statement)

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“…The CET tapers from the musculotendinous junction to its origin at the lateral epicondyle. Its footprint has been defined as approximately 10 mm in anteroposterior width (Nimura et al, 2014), its true tendinous length is approximately 16 mm (Keijsers et al, 2016), its thickness at the radiocapitelar joint is 4.4 mm (Toprak et al, 2012), the average width of the CET at the musculotendinous junction though not previously defined, was 35 mm in the current study. Calculating the volume of an oblique wedge (Stocker & Harris, 1998) (

V = \frac{bh}{6 ()(, 2 a + c)}

) , from these figures yields a volume of 938.66 mm 3 , which is similar to the mean total volume, derived from the pixel density, found in the current study (1040 mm 3 ).…”

Section: Discussionmentioning

confidence: 47%

The spread of Injectate after ultrasound-guided lateral elbow injection – a cadaveric study

et al. 2018

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BackgroundInjections into the tendinous portion of the common extensor origin are a common intervention in the treatment of Lateral Elbow Tendinopathy (LET). Clinical trials report a heterogeneous selection of injectate volumes and delivery techniques, with systematic reviews finding no clear consensus. The aim of this study was to assess the intratendinous distribution and surrounding tissue contamination of ultrasound-guided injections into the Common Extensor Tendon (CET) of the elbow.MethodsTwenty cadaveric elbows were injected by a Consultant Radiologist under Ultrasound guidance. Elbows were randomised to equal groups of 1 or 3 mls of methylene blue injection, delivered using single shot or fenestrated techniques. Following injection, each cadaver underwent a dry arthroscopy and dissection of superficial tissues. The CET was excised, set and divided into 1 mm sections using microtome. Each slice was photographed and analysed to assess spread and pixel density of injectate in four colour graduations. The cross-sectional area of distribution was calculated and compared between groups.ResultsIn all 20 cadaveric samples, contamination of the joint was noted on arthroscopy and dissection. Injectate spread through over 97% of the cross-sectional area. No differences were found in intratendinous spread of injectate between differing volumes or techniques.ConclusionThis study found that commonly used injection volumes and techniques distribute widely throughout cadaveric CETs. There was no improvement when the volume was increased from 1 to 3 mls or between single shot of fenestrated injection techniques. It should be noted that joint contamination using these techniques and volumes may be inevitable.Electronic supplementary materialThe online version of this article (10.1186/s40634-018-0142-8) contains supplementary material, which is available to authorized users.

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V = \frac{bh}{6 ()(, 2 a + c)}

) , from these figures yields a volume of 938.66 mm 3 , which is similar to the mean total volume, derived from the pixel density, found in the current study (1040 mm 3 ).…”

Section: Discussionmentioning

confidence: 47%